Individual
PATRICIA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3547 HABERSHAM AT NORTHLAKE, BUILDING F, TUCKER, GA 30084-4001
(678) 406-9707
(678) 406-9881
Mailing address
2073 SINGER WAY, LITHONIA, GA 30058-5479
(470) 216-4473
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/20/2017
Last updated
02/20/2017
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